WIU Home > Student Services > AOD > Step Up Program > Step Up Registration Form
All fields with * are required
Email Address: *
Phone Number: *
Student Status: *
Please identify which organizations you are involved in and describe as appropriate.
Student Organization: *
Please choose one training date to attend. You must attend the entirety of the training to receive certificate.
Training Date: *
April 14, 2013 6pm-9pm
Individual Group Request
Please choose a maximum of two topics of personal interest. Dependent upon class need, topics may or may not be covered in depth.
Topics Of Interest: *
Alcohol and Alcohol Poisoning
WESTERN ILLINOIS UNIVERSITY - STUSERV
Sherman Hall / 1 University Circle
Macomb, IL 61455 USA